OptimizeRx Reports First Quarter 2026 Financial Results and Updates Fiscal Year 2026 Guidance
Rhea-AI Summary
OptimizeRx (Nasdaq: OPRX) reported Q1 2026 revenue of $19.8 million, down 10% year over year. GAAP net loss narrowed to $0.5 million ($0.03 per share). Non-GAAP net income was $2.7 million ($0.14 per diluted share) and adjusted EBITDA reached $3.3 million.
Cash stood at $20.2 million with $23.6 million of debt. The company refinanced into a $35 million Fifth Third Bank facility, expecting about $1.5 million in annual interest savings, and launched efficiency initiatives targeting $3 million annualized savings. 2026 guidance is $95–$100 million revenue and $21–$25 million adjusted EBITDA.
AI-generated analysis. Not financial advice.
Positive
- GAAP net loss narrowed to $0.5M from $2.2M year over year.
- Non-GAAP net income rose to $2.7M versus $1.5M a year earlier.
- Adjusted EBITDA increased to $3.3M from $1.5M in Q1 2025.
- Debt refinancing expected to cut annual interest expense by about $1.5M.
- Operating efficiency initiatives target $3M in annualized cost savings, including $1M in 2026.
- Revenue per average full-time employee increased to $801K from $710K on a rolling basis.
Negative
- Q1 2026 revenue fell 10% year over year to $19.8M.
- Company remained GAAP unprofitable with a $0.5M net loss.
- Cash and equivalents declined to $20.2M from $23.4M at December 31, 2025.
- Average revenue per top 20 pharma manufacturer decreased to $2.79M from $2.96M.
- Net revenue retention slipped to 110% from 114% on a rolling twelve-month basis.
Market Reaction – OPRX
Following this news, OPRX has declined 9.47%, reflecting a notable negative market reaction. Our momentum scanner has triggered 5 alerts so far, indicating moderate trading interest and price volatility. The stock is currently trading at $5.74. This price movement has removed approximately $12M from the company's valuation.
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Key Figures
Market Reality Check
Peers on Argus
OPRX fell 3.57% while close peers showed mixed performance (e.g., SPOK and TBRG down, DH and SY up), indicating a stock-specific reaction rather than a broad Health Information Services move.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Mar 05 | Full-year 2025 earnings | Positive | -10.5% | Strong 2025 results and guidance update plus new $10M repurchase program. |
| Mar 05 | Q4 2025 earnings | Positive | -10.5% | Record Q4 profitability, full-year growth, guidance and buyback authorization. |
| Nov 06 | Q3 2025 earnings | Positive | -17.4% | Strong Q3 growth, higher guidance for 2025 and initial 2026 outlook. |
| Oct 30 | Earnings call notice | Neutral | +4.5% | Announcement of upcoming Q2 2025 earnings call and access details. |
| Aug 07 | Q2 2025 earnings | Positive | +34.7% | Strong Q2 growth, profitability improvement and raised full-year 2025 guidance. |
Earnings-related news often showed weak or negative next-day price reactions, even when fundamentals or guidance appeared strong.
Across recent earnings events, OptimizeRx reported growing revenue, improving profitability, and repeatedly set or raised guidance, such as full-year 2025 revenue of $109.4M and adjusted EBITDA of $24.3M on Mar 5, 2026. Yet several of these updates were followed by notable share price declines within 24 hours. The current Q1 2026 release, which includes lower revenue and a reduced 2026 revenue outlook versus prior guidance, fits into this pattern of earnings acting as key trading catalysts.
Historical Comparison
In the past five earnings-related releases, OPRX’s average next-day move was about 0.18%, with several sharp selloffs despite positive metrics. Today’s negative reaction to softer Q1 revenue and reduced 2026 revenue guidance continues that pattern of earnings being a key volatility driver.
Recent earnings have highlighted rapid revenue growth in 2025, improving adjusted EBITDA, and initially higher 2026 revenue targets, followed now by Q1 2026 results with lower revenue and a reset 2026 revenue outlook while maintaining adjusted EBITDA guidance.
Market Pulse Summary
This announcement details Q1 2026 revenue of $19.8M, a narrowed GAAP net loss, and higher non-GAAP profitability alongside an updated 2026 revenue outlook of $95–$100M and unchanged adjusted EBITDA guidance of $21–$25M. It also highlights debt reduction, a new $35M banking facility, and cost-efficiency initiatives. When assessing the update, investors may focus on revenue trajectory, margin sustainability, key KPIs such as net revenue retention, and progress on efficiency and refinancing benefits.
Key Terms
adjusted EBITDA financial
non-GAAP financial
net revenue retention financial
revenue per average full-time employee financial
electronic health record technical
demand-side platforms (DSPs) technical
AI-generated analysis. Not financial advice.
– Q1 revenue totals
– Q1 net loss and adjusted EBITDA came in at
– 2026 revenue guidance updated to
– Paid off an incremental
– Completed debt refinancing, subsequent to end of Q1, with a
– Launched operating efficiency initiatives, subsequent to end of Q1, with expected annualized savings of
WALTHAM, Mass., May 12, 2026 (GLOBE NEWSWIRE) -- OptimizeRx Corp. (the “Company”) (Nasdaq: OPRX), a leading provider of healthcare technology solutions helping life sciences companies reach and engage healthcare professionals (HCPs) and patients, today announced results for the three months ended March 31, 2026.
Financial Highlights
- Revenue in the first quarter of 2026 decreased
10% to$19.8 million when compared to$21.9 million in the same year ago period. - GAAP net loss in the first quarter of 2026 narrowed to
$(0.5) million , or$(0.03) per share, compared to net loss of$(2.2) million , or$(0.12) per share, in the same period of 2025. - Non-GAAP net income in the first quarter of 2026 increased to
$2.7 million , or$0.14 per diluted share, compared to Non-GAAP net income of$1.5 million , or$0.08 per diluted share, in the same period of 2025. (see *Non-GAAP Measures below) - Adjusted EBITDA for the first quarter of 2026 increased to
$3.3 million compared to$1.5 million in the same year ago period. (see *Non-GAAP Measures below) - Cash and cash equivalents totaled
$20.2 million as of March 31, 2026 as compared to$23.4 million as of December 31, 2025. - Paid off
$2.7 million of principal and exited the first quarter of 2026 with$23.6 million in debt. - Subsequent to the end of the quarter, the Company refinanced its debt through Fifth Third Bank which lowers the interest rate by 625 basis points, an annual interest expense savings of approximately
$1.5 million , through a$25 million term loan and an undrawn$10 million revolver.
Stephen Silvestro, OptimizeRx CEO commented, “We delivered a solid start to 2026, exceeding consensus for the quarter, reinforcing the strength and resilience of our operating model. While we are seeing some short to intermediate term disruption from ongoing most favored nations (MFN) pricing dynamics and other macroeconomic factors leading to more measured customer spending, we do not view these pressures as enduring obstacles.
“Importantly, the long-term shift toward digital, data-driven engagement across life sciences remains firmly intact and continues to provide a meaningful driver for our business. We are encouraged by the traction we are seeing with existing customers, particularly in instances where they are not directly impacted by MFN, and with mid-tier and emerging clients. As recently announced, we are also expanding our platform capabilities by opening our proprietary electronic health record network to demand-side platforms (DSPs), enabling media buyers to activate scalable, point of care campaigns within their clinical programmatic workflow. Providing programmatic access to DSPs will position us to significantly increase inventory utilization and unlock a new, high-growth revenue channel over time. We believe our differentiated network, deep integrations, and scalable model position us to capitalize on the significant long-term opportunity in front of us.”
| Rolling Twelve Months Ended March 31, | ||||||||
| Key Performance Indicators (KPIs)** | 2026 | 2025 | ||||||
| (in thousands, except percentages) | ||||||||
| Average revenue per top 20 pharmaceutical manufacturers | $ | 2,791 | $ | 2,963 | ||||
| Percent of total revenue attributable to top 20 pharmaceutical manufacturers | 52 | % | 63 | % | ||||
| Net revenue retention | 110 | % | 114 | % | ||||
| Revenue per average full-time employee | $ | 801 | $ | 710 | ||||
2026 Financial Outlook
The Company is updating its fiscal year 2026 guidance, and now expects revenue of
Conference Call, Webcast, and Webcast Replay Information
| Date: | Tuesday, May 12, 2026 |
| Time: | 4:30 p.m. Eastern Time (1:30 p.m. Pacific Time) |
| Toll Free: | 1-877-407-9716 |
| International: | 1-201-493-6779 |
| Conference ID: | 13760191 |
| Call Me: | https://callme.viavid.com/viavid/?callme=true&passcode=13760191&h=true&info=company-email&r=true&B=6 |
| Webcast: | https://viavid.webcasts.com/starthere.jsp?ei=1760247&tp_key=80ee98d522 |
Webcast Replay: The archived webcast will be on the investor relations section of the OptimizeRx website
Individual Meeting Invitation
In an effort to increase relations with institutional investors, OptimizeRx management has dedicated time to hosting individual meetings with portfolio managers and analysts. If you are interested in scheduling a meeting with OptimizeRx management, please contact: adsilva@optimizerx.com or dfarrell@lifesciadvisors.com.
*Non-GAAP Measures
In addition to the financial measures prepared in accordance with generally accepted accounting principles (GAAP), this earnings release also contains non-GAAP financial measures. The reasons why we believe these measures provide useful information to investors and, for historical periods, a reconciliation of these measures to the most directly comparable GAAP measures are included in the supplemental tables that follow.
Although the Company provides guidance for adjusted EBITDA, a non-GAAP financial measure, it is not able to provide guidance to the most directly comparable GAAP measure. Reconciliations for forward-looking figures would require unreasonable effort at this time because of the uncertainty and variability of the nature and amount of certain components of various necessary GAAP components, including, for example, those related to compensation, acquisition expenses, other income, amortization or others that may arise during the year, and the Company’s management believes such reconciliations would imply a degree of precision that would be confusing or misleading to investors. For the same reasons, the Company is unable to address the probable significance of the unavailable information.
**Definition of Key Performance Indicators
Top 20 pharmaceutical manufacturers: We have updated the definition of “top 20 pharmaceutical manufacturers” in our key performance indicators to be based upon Fierce Pharma’s most updated list of “The top 20 pharma companies by 2025 revenue”. We previously used “The top 20 pharma companies by 2024 revenue”. As a result of this change, prior periods have been restated for comparative purposes.
Net revenue retention: Net revenue retention is a comparison of revenue generated from all clients in the previous period to total revenue generated from the same clients in the following year (i.e., excludes new client relationships for the most recent year).
Revenue per average full-time employee: We define revenue per average full-time employee (FTE) as total revenue over the last 12 months (LTM) divided by the average number of employees over the LTM, which is calculated by taking our total number of FTEs at the end of the prior year period by our total FTE headcount at the end of the most recent period.
About OptimizeRx
OptimizeRx is a leading healthcare technology company that’s redefining how life science brands connect with patients and healthcare providers. Our platform combines innovative artificial intelligence (AI)-driven tools like the Dynamic Audience Activation Platform (DAAP) and Micro-Neighborhood Targeting (MNT) to deliver timely, relevant, and hyper-local engagement. By bridging the gap between HCP and DTC strategies, we empower brands to create synchronized marketing solutions that drive faster treatment decisions and improved patient outcomes.
Our commitment to privacy-safe, patient-centric technology ensures that every interaction is designed to make a meaningful impact, delivering life-changing therapies to the right patients at the right time. Headquartered in Waltham, Massachusetts, OptimizeRx partners with some of the world’s leading pharmaceutical and life sciences companies to transform the healthcare landscape and create a healthier future for all.
For more information, follow the Company on X, LinkedIn or visit www.optimizerx.com.
Important Cautions Regarding Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Words such as “anticipates”, “believes”, “estimates”, “expects”, “forecasts”, “intends”, “plans”, “projects”, “targets”, “designed”, “could”, “may”, “should”, “will” or other similar words and expressions are intended to identify these forward-looking statements. All statements that reflect the Company’s expectations, assumptions, projections, beliefs or opinions about the future, other than statements of historical fact, are forward-looking statements, including, without limitation, statements relating to the Company’s future performance, expected revenues, expected adjusted EBITDA, ability to reinforce the strength and resilience of the Company’s operating model, macroeconomics factors not expected to be enduring disruptions, digital, data-driven engagement remaining intact and continuing to be a meaningful driver for the business, current and future traction with existing and new customers, plans to successfully launch programmatic access to the Company’s authenticated EHR network, programmatic access will increase inventory utilization and unlock high-growth revenue channel, ability to capitalize on significant long-term opportunity, plans to grow shareholder value creation, plans to continue the Company’s growth and transformation, plans to position the Company to become a sustained “Rule of 40” company, increased market volatility, engagement across the Company’s network, , and other statements relating to future performance, plans, and expectations. These forward-looking statements are based on the Company’s current expectations and involve assumptions regarding the Company’s business, the economy, and other future conditions that may never materialize or may prove to be incorrect. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted, or quantified. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of various risks and uncertainties including, but not limited to, the effect of government regulation, seasonal trends, dependence on a concentrated group of customers, cybersecurity incidents that could disrupt operations, the ability to keep pace with growing and evolving technology, the ability to maintain contracts with electronic prescription platforms and electronic health records networks, competition, and other factors discussed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2025, its subsequent Quarterly Reports on Form 10-Q, and in other filings the Company has made and may make with the Securities and Exchange Commission in the future. One should not place undue reliance on these forward-looking statements, which speak only as of the date on which they were made. The Company undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made, except as may be required by law.
OptimizeRx Contact
Andy D’Silva, Chief Business Officer
adsilva@optimizerx.com
Investor Relations Contact
Douglas Farrell
LifeSci Advisors, LLC
dfarrell@lifesciadvisors.com
| OPTIMIZERX CORPORATION CONDENSED CONSOLIDATED BALANCE SHEETS (in thousands, except share and per share data) | ||||||||
| March 31, 2026 | December 31, 2025 | |||||||
| ASSETS | (unaudited) | |||||||
| Current assets | ||||||||
| Cash and cash equivalents | $ | 20,169 | $ | 23,365 | ||||
| Accounts receivable, net of allowance for credit losses of | 31,989 | 37,752 | ||||||
| Taxes receivable | 871 | 752 | ||||||
| Prepaid expenses and other | 3,136 | 2,846 | ||||||
| Total current assets | 56,165 | 64,715 | ||||||
| Property and equipment, net | 107 | 106 | ||||||
| Other assets | ||||||||
| Goodwill | 70,869 | 70,869 | ||||||
| Patent rights, net | 4,426 | 4,586 | ||||||
| Technology assets, net | 6,576 | 6,870 | ||||||
| Tradename and customer relationships, net | 28,751 | 29,340 | ||||||
| Operating lease right-of-use assets | 352 | 404 | ||||||
| Security deposits and other assets | 18 | 28 | ||||||
| Total other assets | 110,992 | 112,097 | ||||||
| TOTAL ASSETS | $ | 167,264 | $ | 176,918 | ||||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||
| Current liabilities | ||||||||
| Current portion of long-term debt | $ | 2,000 | $ | 4,255 | ||||
| Accounts payable | 3,066 | 1,636 | ||||||
| Accrued expenses | 3,592 | 11,591 | ||||||
| Revenue share payable | 955 | 3,086 | ||||||
| Current portion of lease liabilities | 177 | 193 | ||||||
| Deferred revenue | 669 | 503 | ||||||
| Total current liabilities | 10,459 | 21,264 | ||||||
| Non-current liabilities | ||||||||
| Long-term debt, net | 21,343 | 21,421 | ||||||
| Lease liabilities, net of current portion | 196 | 234 | ||||||
| Deferred tax liabilities, net | 5,655 | 5,705 | ||||||
| Total liabilities | 37,653 | 48,624 | ||||||
| Commitments and contingencies | ||||||||
| Stockholders’ equity | ||||||||
| Preferred stock, | — | — | ||||||
| Common stock, | 21 | 20 | ||||||
| Treasury stock, | (2 | ) | (2 | ) | ||||
| Additional paid-in-capital | 209,323 | 207,512 | ||||||
| Accumulated deficit | (79,731 | ) | (79,236 | ) | ||||
| Total stockholders’ equity | 129,611 | 128,294 | ||||||
| TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY | $ | 167,264 | $ | 176,918 | ||||
| OPTIMIZERX CORPORATION CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (in thousands, except share and per share data, unaudited) | ||||||||
| For the Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Net revenue | $ | 19,844 | $ | 21,928 | ||||
| Expenses | ||||||||
| Cost of revenues, exclusive of depreciation and amortization presented separately below | 4,912 | 8,584 | ||||||
| Sales and marketing | 4,729 | 4,985 | ||||||
| General and administrative expenses | 3,513 | 4,557 | ||||||
| Research and development | 3,402 | 3,252 | ||||||
| Stock-based compensation | 1,828 | 1,558 | ||||||
| Depreciation and amortization | 1,064 | 1,094 | ||||||
| Total expenses | 19,448 | 24,030 | ||||||
| Income (loss) from operations | 396 | (2,102 | ) | |||||
| Other income (expense) | ||||||||
| Interest expense | (1,155 | ) | (1,297 | ) | ||||
| Other income | 38 | 39 | ||||||
| Interest income | 77 | 88 | ||||||
| Total other expenses, net | (1,040 | ) | (1,170 | ) | ||||
| Loss before provision for income taxes | (644 | ) | (3,272 | ) | ||||
| Income tax benefit | 149 | 1,073 | ||||||
| Net loss | $ | (495 | ) | $ | (2,199 | ) | ||
| Weighted average number of shares outstanding – basic | 18,761,622 | 18,470,808 | ||||||
| Weighted average number of shares outstanding – diluted | 18,761,622 | 18,470,808 | ||||||
| Loss per share – basic | $ | (0.03 | ) | $ | (0.12 | ) | ||
| Loss per share – diluted | $ | (0.03 | ) | $ | (0.12 | ) | ||
| OPTIMIZERX CORPORATION CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (in thousands, unaudited) | ||||||||
| For the Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| OPERATING ACTIVITIES: | ||||||||
| Net loss | $ | (495 | ) | $ | (2,199 | ) | ||
| Adjustments to reconcile net loss to net cash (used in) provided by operating activities: | ||||||||
| Depreciation and amortization | 1,064 | 1,094 | ||||||
| Stock-based compensation | 1,828 | 1,558 | ||||||
| Amortization of debt issuance costs | 358 | 174 | ||||||
| Changes in: | ||||||||
| Accounts receivable | 5,763 | 5,492 | ||||||
| Prepaid expenses and other assets | (290 | ) | 74 | |||||
| Accounts payable | 1,430 | 1,225 | ||||||
| Revenue share payable | (2,131 | ) | (3,310 | ) | ||||
| Accrued expenses and other liabilities | (7,989 | ) | 854 | |||||
| Operating lease liabilities | (2 | ) | — | |||||
| Taxes receivable and payable | (119 | ) | (431 | ) | ||||
| Deferred tax liabilities | (50 | ) | (705 | ) | ||||
| Deferred revenue | 166 | 38 | ||||||
| NET CASH (USED IN) PROVIDED BY OPERATING ACTIVITIES | (467 | ) | 3,864 | |||||
| INVESTING ACTIVITIES: | ||||||||
| Purchases of property and equipment | (21 | ) | (27 | ) | ||||
| Capitalized software development costs | — | (57 | ) | |||||
| NET CASH USED IN INVESTING ACTIVITIES | (21 | ) | (84 | ) | ||||
| FINANCING ACTIVITIES: | ||||||||
| Cash paid for employee withholding taxes related to the vesting of restricted stock units | (17 | ) | (87 | ) | ||||
| Repayment of long-term debt | (2,691 | ) | (500 | ) | ||||
| NET CASH USED IN FINANCING ACTIVITIES | (2,708 | ) | (587 | ) | ||||
| NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS | (3,196 | ) | 3,193 | |||||
| CASH AND CASH EQUIVALENTS - BEGINNING OF PERIOD | 23,365 | 13,380 | ||||||
| CASH AND CASH EQUIVALENTS - END OF PERIOD | $ | 20,169 | $ | 16,573 | ||||
| SUPPLEMENTAL CASH FLOW INFORMATION: | ||||||||
| Cash paid for interest | $ | 798 | $ | 1,121 | ||||
| Cash paid for income taxes | $ | 12 | $ | — | ||||
| OPTIMIZERX CORPORATION RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL MEASURES (in thousands, except share and per share data, unaudited) | ||||||||
| This earnings release includes certain financial measures that are not prepared in accordance with generally accepted accounting principles (GAAP). These non-GAAP financial measures are performance measures that are not defined under GAAP and should be considered in addition to, and not as a substitute for, the most directly comparable GAAP measures. They may also not be comparable to similarly titled measures reported by other companies. Management believes that presenting these non-GAAP financial measures provides useful supplemental information that facilitates comparison of the Company's historical operating results and trends, and offers transparency into how management evaluates the business. Management uses these measures in making financial, operating and planning decisions and in evaluating the Company's performance. Excluding items that management does not consider reflective of ongoing operating results improves the comparability of year-over-year results and helps investors better understand the Company’s underlying performance. These adjustments may include items such as asset impairment charges, amortization, stock-based compensation, acquisition expenses, severance related to executive departures and reductions in force initiatives, shareholder activist related fees, CEO search fees, other income, and other items that management believes are not related to the Company’s ongoing performance. | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Net loss | $ | (495 | ) | $ | (2,199 | ) | ||
| Depreciation and amortization | 1,064 | 1,094 | ||||||
| Stock-based compensation | 1,828 | 1,558 | ||||||
| Severance expenses | 30 | 275 | ||||||
| Shareholder activist related fees | — | 451 | ||||||
| CEO search fees | — | 225 | ||||||
| Other income | (38 | ) | (39 | ) | ||||
| Amortization of debt issuance costs | 358 | 174 | ||||||
| Non-GAAP net income | $ | 2,747 | $ | 1,539 | ||||
| Non-GAAP net income per share | ||||||||
| Diluted | $ | 0.14 | $ | 0.08 | ||||
| Weighted average shares outstanding: | ||||||||
| Diluted | 19,107,036 | 18,579,012 | ||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Net loss | $ | (495 | ) | $ | (2,199 | ) | ||
| Depreciation and amortization | 1,064 | 1,094 | ||||||
| Income tax benefit | (149 | ) | (1,073 | ) | ||||
| Stock-based compensation | 1,828 | 1,558 | ||||||
| Severance expenses | 30 | 275 | ||||||
| Shareholder activist related fees | — | 451 | ||||||
| CEO search fees | — | 225 | ||||||
| Other income | (38 | ) | (39 | ) | ||||
| Interest expense, net | 1,078 | 1,209 | ||||||
| Adjusted EBITDA | $ | 3,318 | $ | 1,501 | ||||
